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NEW YORK (Reuters Health) - The corticosteroid drug budesonide, given as a nasal spray for 6 weeks, benefits children with mild sleep apnea, a study shows.
Obstructive sleep apnea occurs when soft tissues in the nose and throat collapse, blocking breathing for brief but frequent periods during sleep.
Intranasal corticosteroids have been shown to reduce the size of tissues in the upper airway passages, and this has proved to be helpful in children with more severe obstructive sleep apnea, the researchers explain in the medical journal Pediatrics.
To see if the treatment was beneficial for milder apnea, Dr. Leila Kheirandish-Gozal and Dr. David Gozal from the University of Louisville, Kentucky studied 62 children with mild sleep apnea. The children were given a spray of budesonide or an inactive placebo in each nostril at bedtime for six weeks. They then switched over to the other treatment for six weeks.
Budesonide treatment was associated with significant improvements in sleep measures, the researchers report, as well as with significant reductions in adenoid size.
In just over half the children, nighttime breathing became normal with the budesonide nasal spray.
Eight weeks after stopping the budesonide nasal spray, there were still improvements in the degree of respiratory disturbance, and adenoid size.
Administration of placebo produced no changes for most of the measurements.
"This study strongly supports the initiation of intranasal corticosteroid therapy in children with mild obstructive sleep apnea syndrome as the first step in the treatment of these children," the authors conclude.
Rather than resorting to surgery to remove adenoids and tonsils, they add, "We believe that the cumulative experience regarding the use of budesonide would endorse 'temporarily throwing away the scalpel' for those symptomatic children with mild obstructive sleep apnea syndrome."
SOURCE: Pediatrics, July 2008.
